OP0289 INEQUITIES IN ARTHRITIS CARE IN CANADA: AN INTERSECTIONAL ANALYSIS OF BIPOC WOMEN
Authors: E. Wang, A. Chan, K. Lendvoy, E. C. Sayre, M. Canseco, C. L. Koehn, T. L. Fox
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Individuals that belong to ethnic minority groups are at greater risk of developing different forms of arthritis and often experience poorer health outcomes when compared to white patients[1]. BIPOC women are especially susceptible to inequities due to the social determinants of health such as education, income and housing[2]; yet interventions are rarely targeted to meet their specific needs, preferences and values. <h3>Objectives</h3> The aim of this community-led Survey was to identify observable disparities in access to and benefits from health care (HC) services between white and Black, Indigenous and Person of Colour (BIPOC) respondents who identified as Women. <h3>Methods</h3> ACE conducted a 33-question online Survey (Aug 2-19, 2022) in English and French. The Survey was conducted in partnership with Research Co., a public opinion firm. Respondents answered questions regarding sociodemographic information, HC access, HC providers, unfavourable experiences, and information seeking habits. Data were analysed in subgroups and aggregate (including incomplete survey responses). Chi-square tests (exact tests where possible) were used to test for associations. <h3>Results</h3> A total of 1,249 responses were received. 732 (59%) respondents identified as women, 484 (39%) men, 16 (1%) non-binary. Of the women who responded, 163 (22%) identified as BIPOC (including 39 Black, 58 Indigenous, 86 POC), and 569 (78%) as white. Women reported greater barriers to accessing HC compared to men, namely travel (29% vs. 19%) and previous unpleasant experiences (18% vs. 10%). More BIPOC women (68%) experienced barriers compared to white women (56%), the most prominent being time (40% vs. 30%) and language (21% vs. 5%). Overall, interactions with HC providers and rheumatologists were rated similarly between BIPOC women and white women. However, significantly less BIPOC women reported being comfortable asking about medications (27% vs 39%), discomfort (30% vs 43%), and pain (39% vs 50%). When asked what characteristics they looked for in HC providers, significant differences were revealed between BIPOC and white women <b>[Figure 1].</b> Overall BIPOC women (14%) reported experiencing discrimination based on gender twice as often as white women (7%), and seven times as often as white men (2%). Further, BIPOC women were seven times as likely to report experiencing ethnicity-based discrimination "often" (8.7%), when compared to white women (1.2%). Results were even more profound for Indigenous women who were 16 times as likely to report experiencing ethnicity-based discrimination "often" (19.6%), when compared to white women (1.2%). Both BIPOC men and women more often turn to family, friends, coworkers, traditional healers, and elders for health information when compared to white respondents. BIPOC women reported being less trusting of certain information sources when compared to white women, specifically patient organizations (11% vs 21%) and official public health websites (55% vs 70%). <h3>Conclusion</h3> Our findings suggest that BIPOC women face unique and disproportionate barriers as well as complex experiences of discrimination when accessing arthritis care. Importantly, BIPOC respondents, in particular BIPOC women, seem to benefit less from their HC interactions. The data further reinforce current literature that calls for the creation of culturally safe spaces and culturally sensitive resources. It is critical for all levels of the health care system to adopt an intersectional lens to better understand and address systemic inequities. <h3>References</h3> [1]Barnabe C, Joseph L, Belisle P, et al. Prevalence of systemic lupus erythematosus and systemic sclerosis in the First Nations population of Alberta, Canada. Arthritis Care Res. 2012;64(1):138-143. doi:10.1002/ACR.20656 [2]Carter RT, Lau MY, Johnson V, Kirkinis K. Racial Discrimination and Health Outcomes Among Racial/Ethnic Minorities: A Meta-Analytic Review. J Multicult Couns Devel. 2017;45(4):232-259. doi:10.1002/JMCD.12076 <h3>Acknowledgements</h3> This work was made possible by the survey participants, and they have our deepest respect and gratitude. <h3>Disclosure of Interests</h3> None Declared.